How would the risk of abuse be any different than the checks and balances that the law/society put in place to protect seniors from other in-home care (I'm thinking of visiting nurses, home-health aides, etc.). Just have some clearing house that can run potential roommates through the same background check and periodic monitoring.

I concede it is different because a roommate is there for more time, but I wonder if the in-home care protections could be expanded to such roommate situations. DS is an LNA and he had a bunch of background checks and such to jump through as part of his licensure process.

I agree... and that's likely to be the eventual solution...
My concern is the cost... If you ever get a chance, talk to an administrator of a nursing home... even that small home with four or five residents, living in a normal residential setting. DW worked in a nursing home for many years. Even then, the rules and regulations were so severe that profitability was marginal, and even with a large organization supporting the home, it eventually was closed leaving the 50 residents to relocate.

We have come to a point where legal restrictions have smothered good intentions throughout the healthcare industry. Just imagine buying a bed for a qualifying home. The law defined the specifications, and only one or two manufacturers can comply... therefore, the hospital bed that would cost $2500 in the private market, actually costs $20,000... made of stainless steel, and compliant with 15 pages of specifications.

Even the simplest things like checking the patient, or turning him/her every hour to prevent bed sores, is under scrutiny by the inspection team of 5 to 7 government employees. the temperature of meals being served, even combing hair are all parts of an inspection that takes a whole day... and if, the rating goes below a certain level, fines, suspension, or more frequent inspections. We're friends with the administrator in our CCRC complex, and these points are minor compared to some of the requirements. Frankly, I can't see how they can maintain profitability.

It's not that I or anyone would want to throw the protections to the wolves, but those rules and regulations come with a cost... Is Society prepared to pay that cost?

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Someone asked what might be done about this type of situation in other countries, and having lived off and on in Latin America since 1993, I could give a couple of insights.

Yes, of course, there is inter-generational living and it is expected that the family pick up any slack when it comes to taking care of a family member in need. And attitudes towards the elderly are different here than in the States. There is more respect and understanding and it is not unusual to see a young man helping a total stranger across the street or carrying bags for someone who is struggling. Or helping someone off or on a bus.

But what do Expats do?

The focus here is on aging in place with the hiring of help for cleaning, buying groceries, transport and such. Wages are lower here and of course there isn't the cost of providing health care for employees in a situation such as this. Nor does one need to worry about purchasing other sorts of insurance say, in case an “employee” cuts themselves or falls down.

In our town of Chapala, Mexico, there are several assisted living places and 24/7 care places which run about $1500 - $2k a month which includes all meals, transport to visit friends or go to the theater, transport to the doctor's office, room cleaning, laundry service, WiFi, on property nurse or doctor available and such. Medicines are extra, as are diapers, etc. if needed.

I have several links to stories we have done on these places and for a list of them if someone wants to PM me for those. Can't list them here.

Mexico is very aware of this segment of aging population in the States and see it as an economic opportunity for them. Plans for aging-in-place-then-move-to-assisted-living-then-24/7-care are in the works. More assisted living facilities will be springing up as time goes on.

By the way, I agree about the severe regulation limiting viable solutions. People talk about the cost of risk, but do people think about the cost of "safety?" I think we are dealing a bit with this here on this topic.

__________________

__________________In 1991 Billy and Akaisha Kaderli retired at the age of 38. They have lived over 2 decades of this financially independent lifestyle, traveling the globe.

+1 but there is a frightening lack of common sense in most government regulation and a tendency to overcook things.

I think that in many cases family does take up the slack if they are nearby - the problem is that due to the mobility of our society in many cases family are not nearby.

Or...there is no family at all. My husband and I are in that situation. We have no children and zero family members alive. We talk about needing to buy into a progressive care living situation in the future.

There are a couple of them nearby where we live in Florida. The initial cost to buy in is somewhere between $50 and $100k and then a monthly fee for your apartment. When needed, you transition to assisted care then skilled care, and the monthly fees increase as you move. LTC insurance doesn't cover anything until skilled care services are needed.

On average, the monthly fee for an independent living apartment is $2500-$3500 a month. Assisted care is $4500 and skilled $5000-$6000 a month.

For people with no family and limited finanical resources, end of life issues are very, very tough.

__________________ You're only crazy if you're poor. If you have money, you're eccentric.

There is probably nothing stopping individuals from doing these arrangements on an informal basis if they want to. They can do or not do their own due diligence re the other party. No need for some government or other authority (church, not-for-profit, et.) to be involved, as these would understandably create a bureaucracy to CYA if something went wrong.

__________________“Would you like an adventure now, or would you like to have your tea first?” J.M. Barrie, Peter Pan

Or...there is no family at all. My husband and I are in that situation. We have no children and zero family members alive. We talk about needing to buy into a progressive care living situation in the future.

We're in that position too, with siblings that are our age but not in a position to help, and we don't expect any. That's why we're pretty much planning on a CCRC by the time I hit 70. It worked out very well for my mother, and DW's father put off moving out the the house far too long.

Aging is inevitable so there's no point in putting one's head in the sand and ignoring it. So my thought is to put us in a CCRC by the time I'm 70. If we don't need the services, great. But if we don't make the move, and then find we need them, then things get very tough.

We're in that position too, with siblings that are our age but not in a position to help, and we don't expect any. That's why we're pretty much planning on a CCRC by the time I hit 70. It worked out very well for my mother, and DW's father put off moving out the the house far too long.

Aging is inevitable so there's no point in putting one's head in the sand and ignoring it. So my thought is to put us in a CCRC by the time I'm 70. If we don't need the services, great. But if we don't make the move, and then find we need them, then things get very tough.

This may sound strange from one who has been lliving in and touting CCRC's, but there is a caveat. Unlike a retirement community, think The Villages, most CCRC's are occupied by people who are quite a bit older... like mid 80's, and the younger people are commonly widows, who have moved for reasons of safety. At that, in our CCRC villas, (read "Villa" as a regular freestanding home), in our late 70's, we are almost the youngest. While we are very, very happy here, we still have some alternate social lives... in our camp, and in our Retirement Community in Florida, so it has been a gradual transition.

In a CCRC, chances are slim that you'll find people who have the same interests that you currently have at your age. Most of the activities are cards, bingo, going out for lunch, or a day at the casino. Sending you a PM link to our community... (can't post here as it counts as a solicitation). It will give you an idea of what facilities are available in a full featured community (homes, apartments, assisted living, rehabilitation, nursing home, Alzheimer unit).
.................................................. ..
This is not necessarily off topic... Of the 65 regular homes in our community, there are three, where the owner has live in, companion assistance... not an easy thing to come by, but arranged after finding that the local home care providers charge $14 to $16 an hour.

To the point made in the original post, hopefully to establish some means of bringing wants and needs together.

The CCRC's I am aware of require that you enter their community healthy and independent. A fairly thorough health screening is done prior to acceptance, and people are denied if there are any signs that you cannot live independently for a period of time after entry. So for some, waiting may disallow this opportunity.

__________________ You're only crazy if you're poor. If you have money, you're eccentric.

The CCRC's I am aware of require that you enter their community healthy and independent. A fairly thorough health screening is done prior to acceptance, and people are denied if there are any signs that you cannot live independently for a period of time after entry. So for some, waiting may disallow this opportunity.

All CCRC's are not created the same... Much confusion about this...
Ours has regular individual homes, apartments, assisted living quarters, nursing home, Alzheimer unit, Fitness center and a rehab center....

For apartment living, yes... at least one person must be able to be indepndent, and understandably so, since the complex does offer the alternatives.

But, contrary to what many believe, you don't have to "buy in"... with a contract for life... Ours is on an ownership (for homes), or rental basis... Commitment and obligation subject to the same kinds of buy/sell or security deposit as in a regular community. No up-front charges.

How would the risk of abuse be any different than the checks and balances that the law/society put in place to protect seniors from other in-home care (I'm thinking of visiting nurses, home-health aides, etc.). Just have some clearing house that can run potential roommates through the same background check and periodic monitoring.

I concede it is different because a roommate is there for more time, but I wonder if the in-home care protections could be expanded to such roommate situations. DS is an LNA and he had a bunch of background checks and such to jump through as part of his licensure process.

There are companies that provide that service currently. By the time you add in insurance coverage (not cheap) and various other costs and regulations, it requires them to charge a hefty hourly rate.

The reason that a mass-scale clearing house won't work is because where are you going to find people to do the work? Most traditional people already trained in that are already in healthcare settings in hospitals/care communities/doctors offices (nurses, aides, etc.). And most of them probably aren't going to do side gigs for extra money after-hours (they could do it now, and many people don't, either because they're tired or simply because they aren't driven to work more than 40 hours).

So that leaves just random people signing up to provide these services on a large scale. And do you really think any company will put its name on the line by hiring 100 random people to go to someone's home that is elderly and provide care, even with some sort of 'background check'? How do you certify they are qualified and versed well enough in the myriad of healthcare topics - even something as simple as helping to get someone out of a bed could result in an injury (not only to the patient, but even to the caregiver's back!). Add in countless other topics, ranging from bathing to administering medication to even dietary items.

Sure, maybe 80 out of 100 are perfect angels. Maybe 5 have questionable motives. But all it'll take is just 1 even halfway competent person or 1 criminal out of 100 to do something bad/wrong, and the company is then filing bankruptcy because of the resulting lawsuit and inability to get insurance afterwards (not to mention the bad reputation, even though the company did nothing wrong).

It is a good idea, in theory...but I highly doubt you'd find someone in this legal and regulatory climate who can make a go of it. I'd honestly put play money into FOREX before I'd ever invest in a 'healthcare clearinghouse' idea.

All CCRC's are not created the same... Much confusion about this...
Ours has regular individual homes, apartments, assisted living quarters, nursing home, Alzheimer unit, Fitness center and a rehab center....

For apartment living, yes... at least one person must be able to be indepndent, and understandably so, since the complex does offer the alternatives.

But, contrary to what many believe, you don't have to "buy in"... with a contract for life... Ours is on an ownership (for homes), or rental basis... Commitment and obligation subject to the same kinds of buy/sell or security deposit as in a regular community. No up-front charges.

It does sound like there are some different options out there. Good to know.

__________________ You're only crazy if you're poor. If you have money, you're eccentric.

I often wonder why so many people love young children, who are (let's face it) helpless, smelly, and noisy, but even more people seem to loathe and shun elderly people who have simply regressed to the state of young children.

Amethyst

__________________If you understood everything I say, you'd be me ~ Miles Davis'There is only one success – to be able to spend your life in your own way.’ Christopher Morley.

I often wonder why so many people love young children, who are (let's face it) helpless, smelly, and noisy, but even more people seem to loathe and shun elderly people who have simply regressed to the state of young children.

Fear - they see the end their future in the elderly.

__________________Numbers is hard

Although rare, it is possible to read something on this forum you don't agree with and simply move on with your life

It does sound like there are some different options out there. Good to know.

There are multitudes of options. Buy in, straight rental, split the difference, etc. Some offer all three. Search on "senior living arrangements" or similar and read for an hour and you'll get the idea.

But all of these choices require money. In fact, usually require considerable money. This is very different from the "old old people live on less expenses" that is often given as advice to people contemplating early retirement with borderline asset bases.

I often wonder why so many people love young children, who are (let's face it) helpless, smelly, and noisy, but even more people seem to loathe and shun elderly people who have simply regressed to the state of young children.

Amethyst

Erm. I don't really like either of them! But I'm no fit for a caregiver role in either situation. I'm interested in universal design concepts but I'm not even near the frame of mind needed to contemplate my own elderly years. I'm truthfully envisioning a lot of cats and the word "crazy".

__________________
“One day your life will flash before your eyes. Make sure it's worth watching.”
Gerard Arthur Way

But all of these choices require money. In fact, usually require considerable money. This is very different from the "old old people live on less expenses" that is often given as advice to people contemplating early retirement with borderline asset bases.

Yes... For one who is living at the poverty level, "for pay" retirement housing is unaffordable.

In our case, if we should have to move from our villa to an apartment in the same community, it would be a monthly rental. For 1 person, $2000/mo for two $2500. Plus the normal one month's refundable deposit. That includes:
2 meals/day
all utilities
free transportation to shopping, medical, recreation- shows, restaurants etc.
preferred access to assisted living or nursing home
all fitness facilities, inhouse activities
Free TV and Internet... but not phone.

Back to the matter of a practical solution. As I mentioned up front, no way to develop a system for bringing people together under our legal system, but then communes are not created under a legal umbrella either.. and they continue to exist.

We are so accustomed to the idea of "working" for pay that the concept of merging the "wants" of the senior who needs some help to live independently in their own home, and having enough assets to do that...
to the "needs" of the 63 year old widow, who has only minimum Social Security....

I see it working every day... and looking at the statistics that predict the senior "bubble", think that some type of community care will be necessary.Community - Wikipedia, the free encyclopedia
Whether as a group, or as a companion unit some kind of solution will be needed. There are precedents... lets hope it happens sooner than later... With 50 million Americans living below the poverty line, it will be important.

In our case, if we should have to move from our villa to an apartment in the same community, it would be a monthly rental. For 1 person, $2000/mo for two $2500. Plus the normal one month's refundable deposit.

This seems a very sensible arrangement and not cripplingly expensive. A friend is trying to arrange care for her elderly parents, and she is getting quotes in the $20,000 per month range, not the $2,000 range, and that's a tremendous difference. Even with selling the house and cashing out assets, she won't be able to afford this level of care for long.

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